Nationwide Claims Data

Serif Health sources nationwide claims data through strategic partnerships with major health plans, clearinghouses, and data aggregators. Our claims dataset spans 500+ commercial, Medicaid, and Medicare health plans, covering approximately 250 million patient lives across the United States.

This comprehensive claims database contains over 9 billion unique claims records, providing deep insights into actual healthcare utilization patterns, referral networks, and real-world pricing dynamics across different markets and provider types.

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Our claims data serves as a critical validation layer for price transparency filings. By comparing published rates with actual claims payments, we can identify discrepancies, assess accuracy of machine readable files, and provide confidence scores for pricing data across different payers and providers.

This validation process helps healthcare stakeholders understand the reliability of published rates and identifies patterns where negotiated rates may differ from actual reimbursement amounts.

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Beyond validation, our claims data provides rich contextual information including utilization volumes, referral patterns, seasonal trends, and geographic variations in healthcare delivery. This additional context helps stakeholders understand market dynamics and provider behavior patterns.

The data is updated monthly and includes detailed breakdowns by specialty, procedure type, patient demographics, and care settings, enabling comprehensive analysis of healthcare markets and provider networks.